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Painful Unilateral Temporalis Muscle Enlargement: Reactive Masticatory Muscle Hypertrophy

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Abstract

An instance of isolated unilateral temporalis muscle hypertrophy (reactive masticatory muscle hypertrophy with fiber type 1 predominance) confirmed by muscle biopsy with histochemical fiber typing and image analysis in a 62 year-old man is reported. The patient presented with bruxism and a painful swelling of the temple. Absence of asymmetry or other abnormalities of the craniofacial skeleton was confirmed by magnetic resonance imaging and cephalometric analyses. The patient achieved symptomatic improvement only after undergoing botulinum toxin injections. Muscle biopsy is key in the diagnosis of reactive masticatory muscle hypertrophy and its distinction from masticatory muscle myopathy (hypertrophic branchial myopathy) and other non-reactive causes of painful asymmetric temporalis muscle enlargement.

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Abbreviations

A-P:

Antero-posterior

ATP:

Adenosine triphosphate

CNS:

Central nervous system

FLAIR:

Fluid attenuated inversion recovery

MRI:

Magnetic resonance imaging

RMMH:

Reactive masticatory muscle hypertrophy

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Acknowledgments

We thank Dr. Sheldon Winkler, DDS, for his constructive comments.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Pediatrics, Drexel University College of Medicine, Section of Neurology, St. Christopher’s Hospital for Children, Philadelphia, PA, 19134, USA

    Christos D. Katsetos

  2. Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, PA, USA

    Christos D. Katsetos, Sirma Koutzaki & Mark Zarella

  3. Division of Oral and Maxillofacial Surgery, Department of Surgery, Drexel University College of Medicine, Philadelphia, PA, USA

    Michael A. Bianchi & Fizza Jaffery

  4. Penn NeuroCare, Drexel Hill, PA, USA

    Robert Slater

Authors
  1. Christos D. Katsetos
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  2. Michael A. Bianchi
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  3. Fizza Jaffery
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  4. Sirma Koutzaki
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  5. Mark Zarella
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  6. Robert Slater
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Correspondence to Christos D. Katsetos.

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Katsetos, C.D., Bianchi, M.A., Jaffery, F. et al. Painful Unilateral Temporalis Muscle Enlargement: Reactive Masticatory Muscle Hypertrophy. Head and Neck Pathol 8, 187–193 (2014). https://doi.org/10.1007/s12105-013-0480-x

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  • DOI: https://doi.org/10.1007/s12105-013-0480-x

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